Red tribe orthodoxy has a lot of disdain for people with trans identities. Blue tribe orthodoxy has maximal dain for those people. But both tribes are willing to promote pseudoscience to achieve their goals. Singal occupies a narrow sliver of the political possibility space where sympathy for those identities can exist at the same time as supporting evidence-based medicine.
Yes, I think there is a middle ground. Trans people are clearly going through something, and I think a bit more sympathy from the Right, particularly for adolescents wouldn't go amiss. Puberty in the age of social media, anxiety and other mental health challenges is rough. You can hate the policies/movement and still have sympathy for the individuals.
However, I'm not sure that encouraging young people to make one-way decisions (or decisions where we are not yet sure whether they are one way or not) is the correct approach.
> You can hate the policies/movement and still have sympathy for the individuals.
I think people on the right (outright bigots excepted) would say they do have sympathy, and it's for kids who have been influenced by the media or whatever to think that they are the opposite gender.
> However, I'm not sure that encouraging young people to make one-way decisions (or decisions where we are not yet sure whether they are one way or not) is the correct approach.
And I think the response here is that not taking action is also one-way, causing irreversible changes, like to the bone structure.
Before I started transition I read through the available literature (this would be back in 2010-2015 ish, before it was quite so hot button) and the general consensus wasn't with Singals position then. I don't think skepticism ought to be ruled out or anything, but hormone therapy is better studied than the use of most antidepressants at this point. (although it could still use better study on particular dosage and effects - no one seems to have done anything comprehensive on progestin treatment, for instance, even though it's clearly associated with the rest.)
While a considerable amount of research has been published in this field, systematic evidence reviews demonstrated the poor quality of the published studies, meaning there is not a reliable evidence base upon which to make clinical decisions, or for children and their families to make informed choices.
The strengths and weaknesses of the evidence base on the care of children and young people are often misrepresented and overstated, both in scientific publications and social debate.
The controversy surrounding the use of medical treatments has taken focus away from what the individualised care and treatment is intended to achieve for individuals seeking support from NHS gender services.
The rationale for early puberty suppression remains unclear, with weak evidence regarding the impact on gender dysphoria, mental or psychosocial health. The effect on cognitive and psychosexual development remains unknown.
The use of masculinising / feminising hormones in those under the age of 18 also presents many unknowns, despite their longstanding use in the adult transgender population. The lack of long-term follow-up data on those commencing treatment at an earlier age means we have inadequate information about the range of outcomes for this group.
The Cass report is pretty questionable quality wise - it was written with political goals pretty directly in mind and it rules out a lot of studies for not being double blind. (Which is necessarily a hard ask here, medical ethics boards aren't going to let you give hormones to the control group children or anything.)
And that criticism has come from medical boards in the UK and globally, I believe?
Anyway, that's also only for children, which feels politically like a wedge issue. The NHS is very slow at providing HRT and I rather doubt they're treating more than a hundred children for gender dysphoria in any way rn.
This is a common misconception about the review. It is true that none of the studies they looked at were double-blinded but they were still included if they were designed and conducted well enough. In a Q&A shortly after the review's release Cass demonstrates that she is well aware that exclusion based on this would be silly.
The amount of myths circulating about the review prompted the publishing of an FAQ page which deals with some of the more egregious examples (e.g. the claim that 98% of studies were rejected).
What's the basis for the claim that the Cass Review was written with political goals directly in mind? Is this just based on the conclusion of the report, or is there actual substance for this statement?
Most of the criticism of the Cass Review comes from the US. Most of Europe has either stopped prescribing puberty blockers and cross sex hormones for minors or never did in the first place. The UK is joining the consensus among the majority of developed countries regarding treatment of gender dysphoric youth, now the US and Canada stand as the sole outliers.
> What's the basis for the claim that the Cass Review was written with political goals directly in mind? Is this just based on the conclusion of the report, or is there actual substance for this statement?
> Notably, Hilary Cass met with Patrick Hunter, a member of the anti-trans Catholic Medical Association who played a significant role in the development of the Florida Review and Standards of Care under Republican Governor Ron DeSantis.
This meeting was held after the Cass Review was published, so it's odd to try and use it to discredit the review itself. Furthermore, Hilary Cass met with hundreds of people to discuss the findings of the review. Is any researcher who ever speaks with Ron DeSantis simply disqualified in your view? Including research published before meeting him?
> A followup email from Hunter indicates that he met with Cass on September 22, 2022 (ECF 184-1). Even as Paul Vazquez wanted to invite Cass to the Board of Medicine hearing as a subject matter expert, Hunter felt that would put her “in a difficult position”:
Why downplay this link in a discussion about the politicization of science?
The interim report - which had the same findings that gender affirming care in minors had scant evidence - was published in March 2022.
Also, that quote is not appearing anywhere in the linked article. Did you post the wrong link?
Again, is the mere fact that Cass - whose job is to advise governments on healthcare - met with someone in government supposed to disqualify the review as politically motivated? What, specifically, did this DeSantis staffer change in the Cass Review?
This is just straightforward attempts at guilt by association. Given that Cass' job is to advise government on healthcare, meeting with government staffers is hardly surprising.
Again, can you point out how the report was influenced. We have the interim report published before Cass met with this staffer. We have the final report published after this meeting. Can you elaborate on how it was changed at the behest of this staffer?
> Dr Hilary Cass, 66, told The Times last week that one activist had begun posting falsehoods about her landmark review of the treatment of trans children before it was even published.
> She was referring to Alejandra Caraballo, an American attorney, transgender woman and instructor at Harvard Law School’s Cyberlaw Clinic.
> On April 9 — the day before the Cass review was published — Caraballo claimed it had “disregarded nearly all studies” because they were not double-blind controlled ones.
> Double-blind studies see patients randomly given either medicine or a placebo, with neither the patient or doctor knowing which.
> In a post on Twitter/X, Caraballo accused Cass and the review team of holding trans healthcare to an “impossible standard”. This was because, she said, transgender patients could not take hormones “blind”, as the effects of any hormones would fairly quickly become obvious.
> Her tweets were contradicted by the publication of the Cass review hours later.
> During a systematic review, researchers looking at studies on transgender healthcare found no blind control ones — so used another system altogether to determine study quality. Cass told The Times last week how difficult it would be to use blind control studies in relation to trans patients, for the same reasons identified by Caraballo.
> As for Caraballo’s claim that the review team “disregarded nearly all studies”, Cass pointed out that 60 out of 103 studies reviewed were used for the conclusions. They were studies deemed to be of moderate and high quality on the effects of puberty blockers and hormone treatment.
> Despite this, Caraballo’s post has been viewed 871,000 times and has not been deleted.
This is unfortunately quite a typical tactic of activists like Caraballo. They will deliberately lie to further their aims, relying on people who are unaware that their lies are lies to spread this disinformation.
The report basically said that there wasn't a lot of evidence that the treatments in question make people happy in the long run, which is an unusual standard to apply. Usually we look for evidence that medical treatments achieve their medical goals, and leave judgments about what will or won't make someone happy to doctors or patients. (For example, it's questionable whether certain cancer treatments that extend life by only a few months will be a net benefit for patients, but we generally let patients and doctors decide for themselves whether or not to go ahead with them.)
Given that the treatments are meant to address gender dysphoria which is unhappiness caused by a sense of misalignment with one's sexual characteristics I struggle to think of a better measure of success than long-term happiness.
It's a good measure of success, but if we applied the same standard consistently, then all kinds of treatments for all kinds of partially psychological conditions would have to be thrown out.
Also, it's taking a particular position to characterise gender dysphoria as merely a subjective feeling of unhappiness. I do not have any fixed position on what exactly gender dysphoria is, but I believe many trans people see it as far more than just that.
This is not a constant fact, though. In 2021 there were not enough qualified US work eligible candidates to go around. Right now is going to be a very different story for many roles.
I guess this is a case of "don't hate the player, hate the game." although the question remains why they filled the role with an H1B candidate in the first place if they could find locals that could do the job. That piece is clearly unethical and done only for wage suppression.
More like a case of “perhaps dont make judgements if your knowledge on the subject is aprox zero”. Again, same question as upthread - show me how prevailing wage is suppressing the market. The h1b could also been issued years ago like in 2021 for example
OMG - there would be a bidding war for developers! VCs and Shareholders might have to take less profit so they could pay their developers more!! What a dystopian future.
And as far as I can tell, Pittsburgh is in the same country as SF.
According to gadders the definition of ethical is apparently “what’s good for gadders personally”. I don’t see anything ethical about your take - i see nationalism and greed. Misguided at that btw because skilled immigration demonstrably is good for us and good for wage growth. I asked you to prove otherwise and you just gave me some econ 101 vibes crap
usually, they find this local person later. But is it right to replace then? Wage suppression but usually H-1Bs and other work immigration visas are not lower paid at big tech co
To be specific, the suit against the mother was against the mother's estate, since the mother was murdered by the shooter... like right away. The suit was settled by the estate.
The suit against Remington ended in a settlement, probably because Remington didn't want a chance in hell to set any legal precedent. The fact that the families got settlements is really a symptom of how unsettled the issue of gun control is in America. Like it's completely inane that it's fully legal to manufacture and sell AR-15 rifles to basically anyone, BUT that somehow marketing them to civilians is inappropriate. Remington settled because they just don't want any possibility of the status quo moving against them.
This is not even remotely true. I have done a decent amount of shooting, some dedicated training, and own multiple firearms of different types including AR style rifles. Your sort of rhetoric is at best disingenuous and not even remotely true.
If you have ever trained with any rifle you will quickly realize that while there are hunting oriented semi-automatic rifles out there, the minimized recoil, the high rate of fire, the lightweight nature, and all the ergonomic accessories make AR style rifles incredibly fast and easy to shoot. Using a red dot site you can fire two rounds to the chest and one to the head at 25 yards in under 2 seconds with a small amount practice and training. Minimally trained people can do the same with iron sites in under 3.
I am a big fan of the AR platform because of these reasons. They are not unique to the AR, but they are unique to a class of gun that is designed with these characteristics in mind. These are not the characteristics of hunting rifles.
Honesty is important, even if it works against your beliefs!
> I don’t know exactly what compensation they should get, but this does not seem like a healthy or sustainable way for our society to deal with tragedy.
I don't know if it's healthy or sustainable, but it definitely sounds healthier than ignoring the tragedy altogether.
Agreed. It doesn't seem like a long-term solution, but it is the best way we have _right now_ to visit consequences on people/orgs that enabled the tragedy. If our society sees everything in cost/benefit, then increasing the costs of actions that lead to tragedies like this is one of the best things we can do.
They did, if even indirectly. Just like how McDonald's holds some responsibility for the obesity epidemic.
The company that makes rifles makes them to be sold. It is in the company's best interest that as many mass shootings happen as possible. By providing guns, they DID contribute to the tragedy. We can tell, because if they had never produced that gun then it would've never shot anyone.
This doesn't even touch on the fact that the reason gun laws are so lax is because these companies lobby for it to be so. Again, they are incentivized to cause as many people to die as possible. Incentives matter. If mass shootings were the next blue jeans, these companies would quickly overthrow Apple.
Blame is very hard and tricky, but any institution or system in place is responsible for an intuitional failure. And that's what mass shootings are - an institutional failure.
> Not suing others for millions or billions and spreading misery. Nothing can bring those kids back.
> Maybe the government could have offered education and employment guarantees to the families?
The lawsuit wasn't about responsibility or compensation for the school shooting. It was about the years of harassment and death threats that the families of those killed had to endure from people who believed the lies that Alex Jones repeatedly told about them.
> Not suing others for millions or billions and spreading misery. Nothing can bring those kids back.
How about not slandering the parents of the victims causing Jones' followers harass and threaten them? He could have admitted he was wrong (which he only did finally at trial and under oath - far too late), but chose to double down. What about that misery?
Jones is not a victim here. He chose greed, but got owned. The motives of the families, lawyers, etc are whataboutism at best. You're essentially arguing that if somebody throws a punch at another person, said person has no right to hit back because hitting back won't take away your black eye.
> but this does not seem like a healthy or sustainable way for our society to deal with tragedy
I don't know, this, to me, is the proper set of incentives. Nobody wants to lose money, so you better do everything you can to prevent these tragedies. If we just sob a little and move on, the systems in place will not change.
I had the goldbugs and silver bugs in mind- they'd be more than willing to pay exorbitant markup, with the feel-good ennui of it going towards a good cause. These were $100 for a 1/10 gram at the time of writing and now are sold out. Coincidence???
https://www.kentonline.co.uk/gravesend/news/lower-thames-cro...
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